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BACKGROUND: Although non-thyroidal illness syndrome(NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine(f T3) levels in trauma patients requiring massive transfusion have not been reported.METHODS: A prospective observational study comparing 2 groups of trauma patients was conducted. Group M comprised trauma patients requiring massive transfusions(>10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score >9 but not requiring massive transfusions. Levels of f T3, free thyroxine(f T4), and thyroidstimulating hormone(TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion amounts were compared and the inter-group prognosis was evaluated. Results are presented as mean±standard deviation.RESULTS: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50±24 years. In group C one patient died from respiratory failure. The initial f T3 levels in group M(1.95±0.37 pg/m L) were signifi cantly lower than those in group C(2.49±0.72 pg/m L; P<0.01) and remained low until 1 week after admission. Initial inter-group f T4 and TSH levels were not significantly different. TSH levels at 1 week(1.99±1.64 μIU/m L) were higher than at admission(1.48±0.5 μIU/m L) in group C(P<0.05).CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.
BACKGROUND: Although non-thyroidal illness syndrome (NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine (f T3) levels in trauma patients requiring massive transfusion have not been reported. METHODS: A prospective observational study comparing 2 groups of trauma Patients were conducted. Group M successfully trauma patients requiring massive transfusions (> 10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score> 9 but not requiring massive transfusions. Levels of f T3 , free thyroxine (f T4), and thyroid stimulating hormone (TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion counts were compared and the inter-group prognosis was evaluated Results are presented as mean ± standard deviation .RESULTS: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50 ± 24 years. In group C one patient died from respiratory failure. The initial f T3 levels in group M (1.95 ± 0.37 pg / m L) were signifi cantly lower than those in group C (2.49 ± 0.72 pg / m Initial inter-group f T4 and TSH levels were not significantly different. TSH levels at 1 week (1.99 ± 1.64 μIU / m L) were higher than at admission (1.48 ± 0.5 μIU / m L) in group C (P <0.05) .CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.